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Types of treatment for cancer of unknown primary (CUP)

Men and woman discussing unknown primary cancer

This page gives you an overview of the treatments used for cancer of unknown primary. There is information about

 

A quick guide to what's on this page

Types of treatment for cancer of unknown primary (CUP)

If you have CUP, your doctor will use any information they have about the cancer to decide which treatment will be best for you. If during your treatment or follow up the primary cancer becomes known, it is possible that they will change your treatment. The main treatment used for CUP is chemotherapy. Sometimes radiotherapy or hormone therapy may be used.

Because the site of the cancer is not known, surgery is not often used to treat CUP. It may be used in particular circumstances.

Treatment for symptoms

You may hear people refer to cancer treatments as radical or palliative. Radical treatments aim to get rid of the cancer completely. Palliative treatments are used to slow down the growth of the cancer and to relieve symptoms. Palliative treatment may help someone to live longer and to live comfortably, even if their cancer can't be cured.

Palliative treatments are often used to treat people with CUP. This is because it is very difficult to cure a cancer when we don't know what type it is. Also the cancer is usually advanced and has already spread. Most types of cancer cannot be completely cured once they have spread.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating CUP section.

 

 

Chemotherapy

Chemotherapy is the main treatment for cancer of unknown primary because it treats the whole body. As the primary cancer cannot be found, it is useful to have a treatment that circulates through the bloodstream. It can then kill cancer cells wherever they are. Hormone therapy is also a treatment for the whole body. Radiotherapy and surgery are local treatments. So they can only be used in an area the doctor knows contains cancer.

 

Surgery

Because the site of the cancer is not known, surgery is not often used to treat cancer of unknown primary (CUP). It may be used in particular circumstances, for example, if tests on a swollen lymph node showed that you have a squamous cell cancer somewhere in your head or neck. Your specialist would refer you to a specialist surgeon, who may operate on the area containing the node. The surgeon would try to remove all signs of cancer from the area. It is possible that this type of surgery could be a cure for some people with CUP. In this sort of situation surgery would often be followed by a course of radiotherapy. The radiotherapy is to try to kill off any cancer cells that may have been left behind. Occasionally radiotherapy might also be given to the suspected primary site of the cancer.

In other situations, your doctor may suggest surgery to relieve certain symptoms such as bleeding or blockages in the body caused by the cancer.

 

Treatment for symptoms

You may hear people refer to cancer treatments as radical or palliative. Radical treatments aim to get rid of the cancer completely. Palliative treatments are used to slow down the growth of the cancer and to relieve symptoms. Palliative treatment may help someone to live longer and to live comfortably, even if they cannot be cured.

Palliative treatments are often used to treat people with cancer of unknown primary. This is because it is very difficult to cure a cancer if tests cannot find the place where the cancer first started. Cancers that have spread cannot usually be completely cured. But some types of cancer can still be cured even when they have spread and your specialist will check for these first of all.

Cancers are also treated according to their type. The treatment for kidney cancer is different to the treatment for stomach cancer or prostate cancer. If the primary site can't be found, it may be difficult for your doctor to know how best to treat you.

Palliative treatment does not just mean painkillers and anti sickness medicines. Chemotherapy, radiotherapy and surgery can all be used palliatively. They can reduce symptoms without aiming to cure the cancer. For example, surgery may be used to relieve a blocked bowel. The surgeon would remove as much of the cancer as necessary to relieve the blockage even if the cancer had spread to other parts of the body. The surgery would relieve severe sickness and may mean that the person with the cancer feels better and lives longer.

 

Steroids

Steroids are used quite often in cancer treatment. They can be given as part of chemotherapy treatment. They can also be used to help you feel better and control symptoms. Steroids can reduce swelling. Sometimes swelling around a tumour adds to the symptoms it causes. So if the swelling is reduced, this can help to control symptoms such as pain. Steroids may also increase your appetite and generally help you to feel better. They can stop you getting to sleep. If you are having problems with sleeping, ask your doctor if you can take all your steroid tablets in the morning. Taking the steroids early in the day may help. Don't do this without checking with your doctor. And make sure that you don't run out of tablets. Always renew your prescription in plenty of time. Steroid treatment usually has to be tailed off slowly, so don't stop taking steroid tablets without checking with your doctor first. There is detailed information about the side effects of steroids in the cancer treatment section

 

Blood transfusions

It is quite common for people with cancer to become anaemic. This means you don't have enough red blood cells to carry oxygen around your body. Anaemia can make you feel tired and breathless. Blood transfusions are the best way to quickly top up your red blood cells. You have the blood cells into your vein by drip. The drip takes a few hours – exactly how long depends on how many bags of blood you need. You may be able to have this done in the outpatient department or you may be asked to go into hospital overnight.

 

Bisphosphonates

If the cancer has spread to your bones, drugs called bisphosphonates may help to relieve bone pain and reduce bone damage. You have bisphosphonates either as tablets or by injection. You can find out more about bisphosphonates in the cancer treatment section.

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Updated: 24 July 2014